Addressing patients’ cultural needs can build trust and strengthen their relationships with healthcare professionals, providers around the U.S. are learning.
When Ginger Marshall decided to move from Atlanta to Cleveland 10 years ago, a big motivation was to find medical providers who are knowledgeable about her needs and her life as a transgender woman. Marshall found a medical home at MetroHealth through the health system’s PRIDE Health Network. Established in 2007, PRIDE was Cleveland’s first clinic designed to provide healthcare services specifically to the LGBTQ communities.
“I want to be able to go to a clinic where my doctors understand and where they speak my language,” Marshall said. She began volunteering at PRIDE shortly after becoming a patient and took a job as an administrative coordinator there in February.
LGBTQ patients tend to face discrimination and substandard care from healthcare providers, many studies have shown. Because of this, these patients often delay or forgo getting needed medical services. Nearly one-sixth of LGBTQ adults reported experiencing discrimination in healthcare settings, and one-fifth of respondents said fear of discrimination was the reason they didn’t seek medical care, according to a 2018 survey conducted by National Public Radio, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health.
Such factors have contributed to LGBTQ people having generally poorer health compared with the rest of the population, including being at higher risk for chronic diseases. Stigma, insensitivity and lack of awareness about these patients’ medical needs among providers are significant contributing factors.
PRIDE offers a sense of community that is a big attraction for these patients, Marshall said.
But it’s the network’s approach to clinical care that has driven its growth from a single location operating only one day a week to seven locations, plus two specialty clinics for transgender youth, all of which are open at least five days a week. Part of the strategy is addressing patients’ social needs. PRIDE offers programs aimed at reducing food insecurity, unstable housing and unemployment, and provides enrollment assistance for people who need health coverage.
MetroHealth benefits from the trust PRIDE has established with the LGBTQ communities, Marshall said. PRIDE patients are less anxious about getting care from a MetroHealth specialist when a PRIDE provider makes the referral, she said.
“There was that focus that helped me feel comfortable walking in and knowing I didn’t have to explain a bunch of things,” she said.
A growing number of healthcare providers, including the PRIDE Health Network, have established programs designed to better connect them to vulnerable patients in underserved communities by providing comprehensive primary-care services targeted to their specific needs.
Previous community outreach initiatives have heavily focused on bringing healthcare services closer to where patients work and live. While this strategy has increased access, newer approaches seek to build on those efforts by incorporating communities’ cultures to inform how to best deliver care.